Private Autonomic Testing in Sydney
Tired of 6–12 month public hospital wait times? Access private autonomic testing for POTS, small fiber neuropathy, and dysautonomia. Book within days. Results within one week.
Expert Autonomic Specialists
Our private autonomic testing centre is led by highly experienced specialists who understand the complexity of dysautonomia and are committed to rapid, accurate diagnosis.
Are You Experiencing These Symptoms?
Autonomic dysfunction can show up in many ways. If any of these sound familiar, testing can help find the cause.
Why Autonomic Testing?
Your autonomic nervous system controls heart rate, blood pressure, digestion, temperature and sweating. When it malfunctions, symptoms are widespread but standard tests often come back “normal.” Autonomic testing finds what standard tests miss.
Our Comprehensive Testing Protocol
The same advanced autonomic testing as public hospitals — same equipment, same expert interpretation. The difference is the wait.
📊 Active Stand Test with Recovery BP
Continuous blood pressure and heart rate recorded lying down, as you actively stand, and again on return to lying (recovery blood pressure) — to detect POTS and orthostatic hypotension.
💓 Heart Rate Variability
Deep-breathing test assessing the autonomic balance between sympathetic (fight or flight) and parasympathetic (rest and digest) responses.
🫁 Valsalva Maneuver
Assesses cardiovagal and sympathetic adrenergic function by monitoring blood pressure and heart rate changes during controlled breathing pressure.
🤼 Isometric Handgrip
A sustained handgrip drives a reflex rise in blood pressure through the sympathetic nervous system; the size of the rise measures adrenergic (sympathetic) function.
✋ SudoScan Technology
Modern, painless testing for small fiber neuropathy and sudomotor dysfunction. No needles, no heating chambers — sensor plates, under 10 minutes.
Public Hospital vs Private Testing
| What you get | Public hospital | Autonomics Australia |
|---|---|---|
| Wait to be tested | 6 to 12 months | Within days |
| Time to report | 4 to 8 weeks after testing | About one week |
| Appointment flexibility | Limited | Flexible scheduling |
| Continuity of care | Variable team | Same expert team throughout |
| Testing sessions needed | Often multiple visits | All testing in one session |
Rapid Diagnosis & Treatment
Once testing is complete you receive a comprehensive report with expert interpretation and clinical recommendations. A proper diagnosis means you can start targeted treatment instead of managing symptoms in the dark.
Lifestyle modifications
Immediate strategies for managing symptoms — fluid and salt loading, compression garments, physical reconditioning and sleep positioning.
Pharmacological therapy
Targeted medications to address the specific type of autonomic dysfunction identified through testing.
Ongoing monitoring
Follow-up care to assess treatment effectiveness and adjust the management plan as needed.
Frequently Asked Questions
How long is the wait for private autonomic testing?
Appointments are usually available within days, not months. Testing is completed in one session and a written report is provided within about one week.
What conditions does autonomic testing diagnose?
Autonomic testing supports diagnosis of POTS, orthostatic hypotension, small fiber neuropathy, cardiovagal dysfunction, and other forms of dysautonomia. It provides objective data that standard tests usually miss.
Is the testing painful?
No. The standard autonomic tests are non-invasive. SudoScan uses sensor plates — no needles, no heating chambers. Blood-pressure and heart-rate recording uses a finger or arm cuff and ECG electrodes. The most uncomfortable part is the active stand itself, which is the test.
Do I need a referral?
A referral is not required for autonomic testing. Your GP's details are helpful so we can send a copy of the report to your doctor. Please contact us with any questions.
Will I get a Medicare rebate?
This is a private specialist service. Autonomic function testing does not attract a Medicare rebate; none is available for this testing. Please contact us for current testing fees.
Ready to Skip the Wait?
Stop waiting 6 to 12 months for public hospital testing. Get expert autonomic testing with appointments within days and results within one week.
Comprehensive Autonomic Function Testing in One Session
Active stand test with recovery blood pressure, HRV with deep breathing, Valsalva, isometric handgrip, and SudoScan in a single appointment. Reports for referring doctors typically within one week. Combined neurology and cardiology interpretation.
When to Refer
Common indications where autonomic function testing meaningfully changes management.
Orthostatic intolerance
Symptoms on standing — lightheadedness, palpitations, brain fog — with or without measured tachycardia or hypotension in clinic. Identifies POTS and the heart-rate rise on active standing.
Orthostatic hypotension
Sustained postural fall in blood pressure, or symptomatic orthostatic intolerance, where objective characterisation of the orthostatic response and adrenergic baroreflex function is needed.
Small fiber neuropathy
Burning feet, length-dependent sensory symptoms, abnormal sweating, autonomic features with normal nerve conduction studies. SudoScan provides quantitative sudomotor data.
Diabetic autonomic neuropathy
Resting tachycardia, postural symptoms, gastroparesis, erectile dysfunction or unexplained falls in a diabetic patient.
Parkinsonian / synucleinopathy
Suspected MSA, pure autonomic failure, or significant autonomic features in Parkinson's disease. Objective quantification of severity and pattern.
Post-viral / chronic fatigue with autonomic features
Including post-COVID dysautonomia. Quantifies the autonomic component and distinguishes from deconditioning where possible.
Autoimmune & paraneoplastic
Sjögren's, autoimmune autonomic ganglionopathy, paraneoplastic syndromes — where autonomic involvement needs objective documentation.
Pre-treatment baseline
Quantitative baseline before starting agents that may affect autonomic function, or as part of fitness assessment.
Tests Performed
Standard battery completed in a single session. Additional cardiovascular workup available where indicated.
📊 Active stand test with recovery blood pressure
Non-invasive continuous blood pressure (finger or arm) and ECG recorded supine, throughout active standing, and on return to lying (recovery blood pressure). Quantifies orthostatic blood pressure and heart rate responses for POTS, orthostatic hypotension and delayed orthostatic patterns, plus adrenergic baroreflex function.
💓 Heart rate variability with deep breathing
Paced respiration at standard rates to quantify respiratory sinus arrhythmia. Primary measure of cardiovagal (parasympathetic) function.
🫁 Valsalva manoeuvre
Standardised forced expiration against resistance with continuous blood pressure. Yields Valsalva ratio (cardiovagal) and characterises adrenergic phase II/IV responses (sympathetic adrenergic).
🤼 Isometric handgrip test
Sustained isometric handgrip raises blood pressure through a sympathetically mediated reflex; the magnitude of the rise quantifies efferent sympathetic adrenergic function. A blunted response indicates adrenergic failure.
✋ SudoScan / sudomotor function
Electrochemical skin conductance from sensor plates — no needles, no thermoregulatory sweat test required. Quantitative bilateral hand and foot indices for small fiber and sudomotor assessment.
What You Receive
Reports are written for referring doctors — quantitative, contextualised, and actionable.
Structured quantitative report
Results for each domain (haemodynamic, cardiovagal, sympathetic adrenergic, sudomotor) with reference ranges and pattern recognition. Composite autonomic severity is reported where appropriate.
Clinical interpretation
Findings placed in the context of the referral question. Diagnostic impression where appropriate (e.g. POTS, OH, small fiber neuropathy pattern) rather than a list of numbers.
Turnaround
Single-session testing. Written report typically within one week. Same-week phone call for urgent or unexpected findings.
Equipment & Methodology
Same testing modalities used in public hospital autonomic laboratories.
Continuous BP & ECG
Beat-to-beat non-invasive blood pressure with synchronous ECG. Captures rapid transient changes missed by intermittent cuff measurement.
Standardised protocols
Active stand with recovery blood pressure, paced breathing protocols, standardised Valsalva pressures, isometric handgrip — results comparable across visits and against published reference data.
SudoScan electrochemical assessment
Quantitative sudomotor function from hand and foot plates. Sensitive to small fiber autonomic involvement and tracks change over time.
How to Refer
Standard specialist referral. Please include the clinical question and relevant prior investigations.
Referral details
To: Dr Ron Granot (Neurology) or Dr Jason Kaplan (Cardiology)
Address: Suite 301, Level 3, Harley Place, 251 Oxford Street, Bondi Junction NSW 2022
Phone: 02 9388 0615
Online enquiry: eastneurology.com.au/contact
Please include
• The specific clinical question driving the referral
• Relevant past investigations (ECG, Holter, NCS, MRI, bloods)
• Current medications (especially any with autonomic effects)
• Any urgent timing considerations — we triage urgent referrals same-day where possible
Clinical FAQ
When should I refer a patient for autonomic testing?
Orthostatic intolerance with tachycardia or hypotension; postural / orthostatic hypotension; small fiber neuropathy symptoms (burning feet, abnormal sweating, length-dependent sensory loss); suspected central dysautonomia or autonomic failure (e.g. multiple system atrophy, Parkinson's disease); suspected dysautonomia in diabetes, amyloidosis, autoimmune conditions, or post-viral syndromes; and unexplained chronic fatigue with autonomic features.
What tests are performed?
The standard battery includes an active stand test with recovery blood pressure (continuous beat-to-beat blood pressure and heart rate, supine, on active standing and on return to lying), heart rate variability with deep breathing, Valsalva manoeuvre with continuous blood pressure, isometric handgrip, and SudoScan for sudomotor / small fiber assessment. Additional cardiovascular testing is available where indicated.
What is the turnaround time for reports?
Testing is completed in a single session. Written report typically within one week, with same-week communication for urgent or unexpected findings.
What is in the report?
Quantitative results for each domain (haemodynamic, parasympathetic, sympathetic adrenergic, sudomotor), interpretation in the clinical context, diagnostic impression where appropriate, and recommendations for management and follow-up.
How do I refer?
Standard specialist referral to Dr Ron Granot (Neurology) or Dr Jason Kaplan (Cardiology), Suite 301, 251 Oxford Street, Bondi Junction NSW 2022. Telephone 02 9388 0615 or use the booking form. Please include the clinical question and relevant prior investigations.
Are there any contraindications?
Active acute illness, recent vagally-mediated procedures, or inability to tolerate postural changes may require deferral. SudoScan is generally well-tolerated but contraindicated in pregnancy and in patients with implanted electronic devices — please flag these on referral.
Should the patient stop their medications before testing?
It depends on the clinical question. For most baseline assessments, patients can continue usual medications. If you specifically need to characterise autonomic function off treatment, we will discuss medication washout protocols on a case-by-case basis. Please contact us if unsure.
Refer a Patient
Standard specialist referral. One-session testing. Reports within one week.
Book Your Autonomic Function Test Today
Stop waiting years for answers. Fill out the form below and we'll contact you to schedule your appointment. Get tested and receive your results within one week.
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